Are people who die by intentional medication poisoning dispensed those medications in the year prior to death?

Objective: The rate of suicidal poisoning in the United States has increased substantially over the past 20 years. Understanding whether prescription medications used for self-poisoning were recently dispensed would help inform suicide prevention efforts. Alternatively, medications for self-poisoning could have been formerly dispensed or collected from friends, family, or illicit sources. Methods: Among those who died by […]

Interactive effects of acute suicidal affective disturbance and pain persistence on suicide attempt frequency and lethality

Background: Acute suicidal affective disturbance (ASAD) has been proposed as a suicide-specific entity that confers risk for imminent suicidal behavior. Preliminary evidence suggests that ASAD is associated with suicidal behavior beyond a number of factors; however, no study to date has examined potential moderating variables. Aims: The present study tested the hypotheses that physical pain persistence would moderate […]

Selection and use of firearm and medication locking devices in a lethal means counseling intervention

Background: While some suicide prevention initiatives distribute locking devices for firearms and medication, little evidence exists to guide the selection of devices. Aims: This study aimed to describe safety standards for locking devices and compare parental acceptance rates for different types of devices. Method: As part of the larger SAFETY Study, behavioral health clinicians provided free locking devices to parents […]

The rate of fatality and demographic characteristics associated with various suicide methods: A community-based study in Northern Taiwan

Background: Understanding lethality and risk factors of suicide methods is an initial step in suicide prevention. Aims: To investigate the fatality rate and demographic characteristics of various suicide methods. Method: This study enrolled consecutive individuals with episodes of suicide attempts registered in a surveillance database in a city with a high rate of suicide mortality in Taiwan, from […]

Analysis of the cost effectiveness of a suicide barrier on the Golden Gate Bridge

Background: The Golden Gate Bridge (GGB) is a well-known “suicide magnet” and the site of approximately 30 suicides per year. Recently, a suicide barrier was approved to prevent further suicides. Aims: To estimate the cost-effectiveness of the proposed suicide barrier, we compared the proposed costs of the barrier over a 20-year period ($51.6 million) to estimated reductions […]

Suicide notes, attempts, and attempt lethality during episodes of ideation among suicidal soldiers and marines

Objective: Suicide remains a significant public health problem among military personnel despite expanded suicide prevention efforts over the last two decades. It is important to understand the behavioral antecedents of suicide, including the writing of a suicide note, to inform efforts to identify imminent risk. However, the completion of a suicide note increasing the likelihood of […]

Risk factors for serious suicide attempts: Difference between older and younger attempters in the emergency department

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters […]

Long gun suicides in the state of Maryland following the firearm safety act of 2013

Objectives In 2013, the state of Maryland passed the Firearms Safety Act limiting the private sales of handguns, which did not apply to long guns often used for hunting (e.g., rifles and shotguns). This decreased the accessibility of handguns relative to long guns. We assessed the frequency of long gun suicides in the years before […]

Risk factors for serious suicide attempts with high medical severity

Objectives his study investigated the risk factors leading to serious suicide attempts with high medical severity. Methods Nine hundred and eighty-two patients who visited the emergency room after attempting suicide were divided into two groups: suicide attempters with high medical severity (25.3%) and those with low medical severity (74.7%). Demographic variables, clinical characteristics, and factors […]

Lethal means assessment and counseling in the emergency department: Differences by provider type and personal home firearms

Objective This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home. Methods Emergency department providers (physicians and mid-level practitioners) and behavioral health (BH) providers […]

Life experiences preceding high lethality suicide attempts in adolescents at a level I regional trauma center

Objective To describe life experiences associated with patterns of medically treated and documented self-directed violence among youth who attempted suicide using highly lethal means to understand precipitating factors among youth using such lethal means. Method Using data from a regional, level 1 Trauma center, we identified all youth suicide attempt survivors who received treatment from […]

Exploring the relationship between domestic violence perpetration and suicidal behavior in male prisoners

This study is the first to explore the relationship between domestic violence perpetration and suicidal behavior in prisoners in England and Wales. The nature of this relationship is unclear, however, understanding and reducing suicide in prisons is a critical issue for frontline staff and policy makers. Eight participants with a history of suicide attempts and […]

Impulsivity and aggression in suicide ideators and suicide attempters of high and low lethality

Background Impulsivity and aggression have been associated with all forms of suicidal behaviour and linked to theories of suicide capability. There is a need to clarify the role of impulsivity and aggression in the progression from suicidal thoughts to suicide attempts and suicide. Method In this naturalistic cross-sectional study, suicide ideators (35), low lethal suicide […]

Prevention of suicidal behavior

More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, […]

Reducing suicide without affecting underlying mental health: Theoretical underpinnings and a review of the evidence base linking the availability of lethal means and suicide (IN: The International Handbook of Suicide Prevention, 2nd ed., edited by R. C. O’Connor & J. Pirkis)

This chapter provides a synthesis of the empirical literature that assesses the relationship between ready access to highly lethal means of suicide and overall suicide rates. It lays out the theoretical underpinnings of the assertion that reducing access to lethal means of suicide can reduce suicide rates. The most convincing evidence that restricting access to […]

Three leading suicide methods in the United States, 2017–2019: Associations with decedents’ demographic and clinical characteristics

Background and aims: The U.S. suicide data show that use of lethal methods, specifically firearms and hanging/suffocation, has been increasing among young and middle-aged adults of both sexes over the past decades. In this study, we examined demographic and clinical correlates of use of firearms, hanging/suffocation, and poisoning as suicide methods among suicide decedents age 18+. […]

Frequency of clinicians’ assessments for access to lethal means in persons at risk for suicide

Objective We measured the frequency of clinicians’ assessments for access to lethal means, including firearms and medications in patients at risk of suicide from electronic medical and mental health records in outpatient and emergency settings. Methods We included adult patients who reported suicide ideation on the PHQ-9 depression screener in behavioral health and primary care […]

Lethal means assessment in psychiatric emergency services: Frequency and characteristics of assessment

Objective Lethal means safety is an effective suicide prevention strategy with demonstrated results at the population level, yet individual-level uptake is less well understood. Methods Using automated data extraction methods, we conducted an investigation of electronic health records from psychiatric emergency service (PES) patients from January 1, 2012 to December 31, 2017 at a busy […]

Attempted suicide: Does lethality matter?

Objectives: To investigate whether high-lethality suicide attempters align to the demographic and clinical features observed in completed suicide in the national and international literature, and whether low-lethality attempters more closely align with the clinical profile of non-attempter ideators. Methods: A retrospective chart review of adult suicide ideators and attempters presenting to an urban tertiary care […]

The serious suicide attempts approach for understanding suicide: Review of the psychological evidence

The study of survivors of a serious suicide attempt (SSA)––an attempt that would have been fatal had it not been for the provision of rapid and effective emergency treatment––can help researchers understand the suicidal mind. Serious suicide attempters are epidemiologically very similar to those who died by suicide, and thus can serve as valid proxies for studying […]

Trends in the incidence and lethality of suicidal acts in the United States, 2006 to 2015

IMPORTANCE Understanding changes in the incidence rates and lethality of suicidal acts may explain increasing suicide rates. OBJECTIVE To examine trends in the incidence rates and lethality of suicidal acts from 2006 to 2015 among persons aged 10 to 74 years. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted from May 2, 2018, to […]

Trends in the incidence and lethality of suicidal acts in the United States, 2006-2015

Importance  Understanding changes in the incidence rates and lethality of suicidal acts may explain increasing suicide rates. Objective  To examine trends in the incidence rates and lethality of suicidal acts from 2006 to 2015 among persons aged 10 to 74 years. Design, Setting, and Participants  This cross-sectional study was conducted from May 2, 2018, to January 30, 2019. […]

What are reasons for the large gender differences in the lethality of suicide acts? An epidemiological analysis in four European countries

BACKGROUND: In Europe, men have lower rates of attempted suicide compared to women and at the same time a higher rate of completed suicides, indicating major gender differences in lethality of suicidal behaviour. The aim of this study was to analyse the extent to which these gender differences in lethality can be explained by factors […]